Do you get lower back or neck pain when doing twisting or rotational movements?

Have you resigned yourself to living with that nagging rotator cuff pain that flares up during workouts and in bed?

If you answered “yes” to any of those (and most people will answer yes to at least one), you may have poor thoracic spine mobility. Even if you don’t notice any of the symptoms leaping out at you, it never hurts to get more mobility, especially in the thoracic spine. And establishing good habits by actively maintaining and training mobility, as opposed to being content with what you have (even if it’s not optimum), is always a good move. Scoff at the prospect of thoracic spine mobility all you want; you still gotta have it.

You can read a ton about it nowadays on the better fitness blogs and forums, but mainstream thoracic spine awareness is fairly recent. It used to be the sole province of specialized physical therapists and chiropractors (and even they failed to emphasize mobility), and the general citizenry have lived their lives without even considering the nuances of the various spinal vertebrae. They know “lower back” (because it probably hurts on a regular basis!) and they know “spine,” and that’s it. They’re bending with their lower backs, misusing their lumbar spines, while their thoracic spines curve from misuse. As a result, a nation of chronic shoulder slumpers has developed, and when those slumpers attempt to lift heavy things, pick up groceries, and throw footballs with their immobile, underutilized thoracic spines, bigger, acute injuries arise.

After the hips, thoracic spine mobility is probably the most crucial aspect of mobility. At least with the hips, though, people can identify them and grasp the concept of hip mobility[3] just by reading text on the computer. Sticking your hips back [4]is pretty self-explanatory. What about the thoracic spine? It’s a bit more nebulous.

Do you know how to use your thoracic spine? Are you even aware that it exists?

Honestly, I doubt it. It’s not that people ignore the thoracic spine willfully; it’s that they’re unaware of any distinctions between spinal and lumbar vertebrae. They know about the spine, and imagine it to be a uniform vertebral column, equally capable of bending, twisting, and rotating along its length. This is totally understandable. “Spine” is what we hear, not “thoracic spine” or “lumbar spine” or “cervical spine,” but it’s much more than that. People simply don’t know any differently. And if you do hear about the thoracic spine from an “expert,” they’re liable to tell you the thoracic spine is meant to be immobile. Yeah, I don’t get it either. Maybe they’re just so used to working with folks who have immobile thoracic spines that they can’t even imagine a mobile one.

We have to know what we’re talking about when we use words, or else they’re useless or dangerous. Words describing anatomy, anatomy that figures prominently into dynamic human movement pattern, require special care. The human spinal column is composed of five segments: the cervical spine, which extends up the neck to the base of the skull; the thoracic spine, which encompasses the shoulder and chest area; the lumbar spine, also known as the lower back; the sacrum; and, finally, the coccyx, or tail bone (the last two of which are lumped together as “Pelvic” in the graphic to the right). The various vertebrae weren’t given different names for fun. Each performs a different role. Each has different capabilities, different functions. Most importantly, each segment of the spine is designed for a certain range of motion. We’re mostly concerned with the lumbar and thoracic spine.

The thoracic spine is built for rotation, flexion, and extension. It is highly mobile – or, rather, it has the potential for lots of mobility. Because of its mobility, the thoracic spine must be used, must be moved. But it has to be known. If people are unable to visualize and feel the movement of the thoracic spine, or if they’re unable to even grasp the concept of its existence, they’ll just attempt to twist, rotate, flex, and bend with something familiar to them: the lumbar spine. That’s bad news.

The lumbar spine is built for stability. It’s supposed to support the weight of the body (plus any added weights) and resist excessive rotation and twisting. It remains stable and acts as a conduit for power generated by the hips and fed to the mobile thoracic spine. It is not meant to twist and bend and do all sorts of the acts that active, thoracically-immobile folks expect it to. It can move, obviously, but it’s not meant to be wildly mobile. It’s meant to be solid, reliable.

Popular fitness trends have gotten people obsessed with “working the core.” I have no qualms with the idea of “working the core,” but people tend to fixate solely on two aspects of the core. Isolate the abs and the lower back. Crunches and weighted lower back extensions. The “core” is much more than a six pack and some lower back musculature. It’s the hips, it’s the lumbar spine, it’s the abs, and it’s the thoracic spine.

The real danger in thoracic spinal immobility lies in its seeming innocuousness. Because thoracic spine immobility is so commonplace, people don’t notice that anything is wrong. Nearly everyone slumps when they sit, and very few people perform the type of exercises that require full range of motion in the spine. You can get away with poor mobility if all you’re doing is isolation exercises on machines, just as millions of people “get away with” the SAD. How many times have you told people who balk at your eating habits to just “try it for thirty days and see how you feel”? If you’re (they’re) lucky, they’ll ditch the sugar[5] and the grains[6] and notice an incredible difference. But you’ll never know the difference until you give the other side a fair shot. You’ll never know how beneficial a mobile thoracic spine can be without developing its mobility. C’mon – you trusted me on grains, sugars, and vegetable oils[7], didn’t you?

You’ll find that an immobile thoracic spine isn’t just bad for the vertebrae themselves. It’s bad for your lower back and your shoulders, too. In fact, you’ll rarely feel actual pain along the twelve vertebrae that comprise your thoracic spine. Instead, your lower back will take over work for which it’s really not designed, getting chronic pain for its troubles, and your scapula (shoulder blades) will compensate by moving away from the spine, making overhead shoulder work difficult, dangerous, and painful, and a rotator cuff injury nearly inevitable. Everything in the body is linked, remember, and you can’t remove a major player from the equation without seriously affecting the balance.

The Benefits

With improved thoracic mobility, you’ll enjoy:

Lack of kyphosis – The bowing of the upper back, endemic in offices across the country, is almost entirely due to poor thoracic mobility. Improve your mobility, try to cut back on all the sitting[8], and your posture will improve and your pain will go away.

A less painful, more stable lower back – Your lumbar spine will be free to provide stability, rather than make up for your lack of mobility.

Healthier shoulders – No longer will a rounded upper back prevent natural scapular action during overhead movements, thus reducing the chance of rotator cuff impingement. For a fun (scary) test, exaggerate the round in your upper back; create a real hump, then try to press your arms overhead. You don’t want that to be your regular state, do you?

Greater range of motion – By finally engaging your thoracic spine in times of spinal rotation, flexion, and extension (like throwing a ball or a punch), instead of your lumbar spine, you will get stronger, faster, and more explosive in those movements.

I was lucky enough to be able to consult an expert on the spine for this and tomorrow’s article. Maya White[10] has some tips that you should keep in mind about thoracic mobility from the Gokhale Method[11] perspective:

Dos and Don’ts Around Thoracic Mobility

Do use thoracic mobility to:
a. Lengthen and straighten your thoracic spine
b. Breathe more deeply (longer, more relaxed muscles in the spine allow for more movement with the breath)
c. Enable your shoulders to roll further back without swaying the low back

Don’t use thoracic mobility to:
a. Hunch your thoracic spine
b. Hyper-extend your thoracic ligaments creating laxity in the ligaments and hyper-mobility in the thoracic spine. (The ligaments are not very elastic tissue, and continually overstretching them can lead to progressively more and more rounding – this is why is is not uncommon to see people in their 80s or 90s who have almost U-turns in the backs)

In sum, it is important to develop thoracic mobility in a precise way that allows healthy spinal architecture and movement and not in a wanton way that threatens your skeletal integrity or scaffolding. Loosening up the thoracic spine and then using that extra mobility to round or distort the spine further while sitting or standing is in some ways worse than being inflexible. It is therefore crucial to be conscious of posture[12] as well, so that your whole spine is well-aligned throughout your day, and any extra mobility you create in your thoracic spine works to your advantage and towards making you straighter and taller.

To learn more about your spine and posture, and whether you have back pain or not I highly recommend the Gokhale Method handbook, 8 Steps to a Pain-Free Back[13].

Tomorrow, I’ll introduce a few strategies for regaining and maintaining thoracic spine mobility. Thanks for reading and Grok on!